Abstract

Introduction: Malaria is a disease of public health concern and in endemic areas, pregnant women and children under-five years are vulnerable to the disease.

Objectives: This study investigated the perceptions and acceptance of the malaria vaccine (RTS,S/AS01) among mothers in the Bonadikombo Community, Cameroon. Specifically, the study seek to assess the level of awareness of the malaria vaccine among caregivers and mothers, evaluate the acceptance rates of the malaria vaccine among mothers  and to evaluate the factors influencing the acceptance of the malaria vaccine among mothers in the Bonadikombo Community.

Methods: A cross-sectional quantitative design was employed, with data collected from 50 caregivers using structured questionnaires.

Results: The findings revealed low awareness levels, with only 36% of respondents knowledgeable about the vaccine. Despite this, acceptance rates were moderate (66%), though actual uptake lagged at 36%, highlighting a gap between willingness and action. Key barriers included misconceptions about vaccine safety and efficacy (46% doubted effectiveness), cultural/religious beliefs (31.3%), and logistical challenges such as distance to health centers (44% unwilling to travel). Trusted information sources were health workers (36%) and radio/TV (28%), while myths (44%) and lack of education (72% had never attended a vaccination session) hindered acceptance. Factors like community leader endorsements (70% acceptance if recommended) and incentives (88% approval) emerged as potential facilitators.

Conclusion: The study concludes that while there is a moderate level of acceptance (66%) of the malaria vaccine among mothers in the Bonadikombo Community, significant gaps in awareness (only 36% had heard about the vaccine) and misconceptions persist, particularly regarding its eligibility, benefits, and safety.

Recommendations: These findings are critical for policymakers and healthcare providers aiming to reduce malaria-related morbidity and mortality in endemic regions.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Malaria remains a significant global health challenge, particularly in sub-Saharan Africa, which accounts for approximately 95% of all malaria cases and deaths worldwide (WHO, 2023). In 2022, there were an estimated 247 million malaria cases globally, with 619,000 deaths, predominantly among children under five.

Africa bears the heaviest burden, with countries like Nigeria, the Democratic Republic of Congo, and Cameroon reporting high incidence rates. In Cameroon, malaria is endemic and a leading cause of morbidity and mortality, with 5.7 million suspected cases and 2,481 deaths reported in 2022 (WHO, 2024). The disease disproportionately affects rural and underserved communities, where access to preventive measures remains limited.

Despite interventions like insecticide-treated nets and antimalarial drugs, progress has stalled, underscoring the need for innovative solutions such as the malaria vaccine. The introduction of the RTS,S/AS01 vaccine in Cameroon in 2024 marked a critical step, yet its success hinges on community acceptance and uptake. Addressing low awareness and misconceptions is vital to reducing the malaria burden in high-risk regions like Cameroon.

The disease is caused by the Plasmodium parasite, transmitted through the bites of infected Anopheles mosquitoes. Despite the availability of various preventive measures, such as insecticide-treated nets (ITNs) and antimalarial drugs, malaria continues to pose a severe threat to public health, particularly in rural and underserved communities (Bam et al., 2023). The introduction of the malaria vaccine, known as RTS, S/AS01, has been a significant milestone in the fight against malaria, offering hope for reducing the disease burden. However, the success of this vaccine depends largely on its acceptance and uptake by the target population, particularly caregivers and mothers who make health decisions for their children.

The acceptance of vaccines, including the malaria vaccine, is influenced by various factors, such as awareness, perceptions, and cultural beliefs (Ajayi & Emeto, 2023). Awareness refers to the level of knowledge and understanding that individuals have about the vaccine, including its benefits, availability, and potential side effects. In many malaria-endemic regions, awareness of the malaria vaccine remains low, particularly among caregivers and mothers in rural areas. This lack of awareness can lead to misconceptions and hesitancy, which ultimately affect vaccine uptake (Chukwuocha et al., 2018). For instance, in a study conducted in Nigeria, only 48.2% of caregivers were aware of the malaria vaccine, despite high levels of awareness about malaria as a public health issue. This highlights the need for targeted health education campaigns to improve awareness and address misconceptions.

Perception, another critical variable, refers to how individuals interpret and make sense of information about the malaria vaccine. Perceptions are shaped by personal beliefs, attitudes, and experiences, which can either positively or negatively influence vaccine acceptance (Olumide et al., 2025). For example, some caregivers may perceive the vaccine as effective and safe, leading to higher acceptance rates, while others may have concerns about potential side effects or doubts about its efficacy. These perceptions are often influenced by cultural and social norms, which play a significant role in shaping health behaviours. In a study conducted in Malawi, Simbeye et al. (2024) found that cultural beliefs and misconceptions about the vaccine’s safety were significant barriers to its uptake, particularly among less educated populations.

Acceptance, the willingness of caregivers and mothers to receive or endorse the malaria vaccine for their children, is a crucial determinant of vaccine uptake. Acceptance is influenced by a combination of factors, including awareness, perceptions, and access to healthcare services (Asmare, 2022). In some communities, acceptance rates are high, with caregivers expressing a strong willingness to vaccinate their children. For instance, in a study conducted in Nigeria, 96.2% of caregivers expressed willingness to accept the malaria vaccine if it were made available (Onyekachi et al., 2021). However, in other regions, acceptance rates are much lower, often due to fear of side effects, lack of trust in the healthcare system, or logistical barriers such as long travel distances to vaccination centres.

Cultural beliefs and social norms also play a significant role in shaping vaccine acceptance. In many African communities, health decisions are often influenced by traditional beliefs and practices, which can either support or hinder vaccine uptake (Tabiri et al., 2021). For example, some caregivers may believe that malaria is caused by supernatural forces rather than mosquito bites, leading to scepticism about the effectiveness of the vaccine. Additionally, social norms, such as the influence of family members or community leaders, can significantly impact vaccine acceptance. In some cases, caregivers may be hesitant to vaccinate their children if they perceive that their community or family does not support vaccination.

Access to healthcare services is another critical factor influencing vaccine acceptance. In many rural and underserved communities, access to healthcare facilities is limited, making it difficult for caregivers to vaccinate their children (Simbeye et al., 2024). Long travel distances, lack of transportation, and financial constraints are common barriers that prevent caregivers from accessing vaccination services. Additionally, the availability of the vaccine itself can be a challenge, particularly in regions where healthcare infrastructure is weak. These logistical barriers can significantly reduce vaccine uptake, even among caregivers who are willing to vaccinate their children.

The role of healthcare providers and community health workers in promoting vaccine acceptance cannot be overstated. Healthcare providers are often the most trusted source of information for caregivers and mothers, and their recommendations can significantly influence vaccine uptake (Ajayi & Emeto, 2023). Community health workers, who are often members of the local community, can also play a crucial role in addressing misconceptions and promoting the benefits of the malaria vaccine. However, in many regions, healthcare providers and community health workers are under-resourced and overburdened, limiting their ability to effectively communicate with caregivers and promote vaccine acceptance.

1.2 Statement of the Problem

In Cameroon, malaria remains one of the leading causes of morbidity and mortality, particularly affecting young children and pregnant women. Despite the availability of effective prevention measures, including the malaria vaccine, many local communities continue to struggle with high infection rates (WHO, 2024). This situation is exacerbated by various factors, such as limited awareness of the vaccine and persistent misconceptions about its efficacy and safety. As a result, mothers in these communities may be hesitant to accept the vaccine, which directly impacts their children’s health and well-being.

The problem is particularly pronounced in rural areas, where access to healthcare information and services is often limited. Mothers may lack sufficient knowledge about the malaria vaccine, including its benefits and the importance of immunization. This lack of awareness contributes to negative perceptions about vaccination, leading to lower acceptance rates. Furthermore, cultural beliefs and social norms can influence how caregivers view the vaccine, creating additional barriers to its uptake. Understanding these perceptions is crucial for addressing the underlying issues that hinder vaccination efforts in these communities.

Mothers may have different views based on their knowledge, experiences, and cultural beliefs. These perceptions can significantly impact whether they choose to vaccinate their children. It is crucial to identify these factors to understand why some individuals may be hesitant or refuse the vaccine. If awareness and perceptions are low, acceptance is likely to be low as well. This study aims to explore these relationships to develop strategies that can effectively promote the malaria vaccine within the community.

This study was undertaken due to the urgent need to bridge the gap between vaccine availability and community acceptance. By examining the factors influencing vaccine hesitancy, this study aims to provide actionable insights for public health strategies. Additionally, the researcher’s background in nursing and firsthand observations of malaria’s impact in endemic regions motivated this investigation. Ultimately, improving vaccine acceptance could significantly reduce malaria-related deaths and enhance child health outcomes in Bonadikombo and similar communities.

1.3 Research Question

1. What is the level of awareness of the malaria vaccine among mothers in the Bonadikombo Community?
2. What are the acceptance rates of the malaria vaccine among mothers in the Bonadikombo Community?
3. What factors influence the acceptance of the malaria vaccine among mothers in the Bonadikombo Community?

Read More: Nursing Project Topics with Materials